The Obesity Paradox in Cancer: How Important Is Muscle?

The Obesity Paradox in Cancer: How Important Is Muscle? Annu Rev Nutr. 2018 May 04;: Authors: Cespedes Feliciano EM, Kroenke CH, Caan BJ Abstract Although higher body mass index (BMI) increases cancer incidence, it is associated with improved survival among patients with existing disease; thus, the relationship of BMI with mortality in cancer patients is often U-shaped, which is termed the obesity paradox. This review discusses possible explanations for the obesity paradox, the prevalence and consequences of low muscle mass in cancer patients, and future research directions. It is unlikely that methodological biases, such as reverse causality or confounding, fully explain the obesity paradox. Rather, up to a point, higher BMI may truly be associated with longer survival in cancer patients. This is due, in part, to the limitations of BMI, which scales weight to height without delineating adipose tissue distribution or distinguishing between adipose and muscle tissue. Thus, cancer patients with higher BMIs often have higher levels of protective muscle. We assert that more precise measures of body composition are required to clarify the relationship of body size to cancer outcomes, inform clinical decision-making, and help tailor lifestyle interventions. Expected final online publication date for the Annual Review of Nutrition Volume 38 is August 21, 2018. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimat...
Source: Annual Review of Nutrition - Category: Nutrition Authors: Tags: Annu Rev Nutr Source Type: research